Healthcare Provider Details

I. General information

NPI: 1932929858
Provider Name (Legal Business Name): SUMMER ALLEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 S 17TH ST
WILMINGTON NC
28401-7407
US

IV. Provider business mailing address

404 ARDAN OAKS CIR
CAPE CARTERET NC
28584-8969
US

V. Phone/Fax

Practice location:
  • Phone: 252-646-5366
  • Fax:
Mailing address:
  • Phone: 252-646-5366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5025268
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number309667
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: